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FUNCTIONAL ANATOMY Additionally, the tibialis anterior helps support the medial or longitudinal arch of the foot. Its tendon traverses the dorsal ankle from lateral to medial and deep under the extensor retinaculum. Here it bends medially around the malleolus prior to attaching on the plantar surfaces of the medial cuneiform and base of the first metatarsal. This tendon angle gives the tibialis anterior leverage to raise the center of the medial arch and prevent the foot from flattening or rolling inward (pronation). The tibialis anterior works synergistically with the tibialis posterior to dynamically maintain the medial arch and limit or control foot pronation. Overuse, weakness, or imbalance Lippincott Williams & Wilkins Figure 09.18 Dragonfly Media Group 03/11/09 may create irritation or tendonitis in the tibialis anterior. This is common when initiating or progressing physical activities such as walking or running too rapidly. Excessive foot pronation or lack of support in the medial arch may also irritate the tibialis anterior, the tibialis posterior, the plantar fascia, or any combination of these. Repetitive stress and inflammation in the tibialis anterior is one of several conditions commonly called "shin splints." CAEL: Functional Anatomy: A Guide of Musculoskeletal Anatomy for Profs PALPATING THE TIBIALIS ANTERIOR Positioning: client supine 1. Standing at the client's feet, locate the lateral edge of the client's tibial shaft with your thumb. 2. Slide laterally onto the muscle belly of the tibialis anterior. 3. Continue to palpate distally toward the front of the ankle and medial arch. 4. Resist as the client performs ankle dorsiflexion and inversion to assure proper location. therapist, and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Kinesiology and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at functionalbook@hotmail.com. Christy Cael is a licensed massage Client Homework— Standing Shin Stretch 1. Stand up straight and steady yourself with one hand if needed. 2. Bend one knee and grasp the top of your foot as you pull it behind you. 3. Gently point your foot as you pull your heel toward your buttock. 4. Maintain upright posture and a straight line between your hip and knee. 5. Breathe deeply as you focus on stretching the front of the ankle and shin. Editor's Note: The Client Homework element in Functional Anatomy is intended as a take-home resource for clients experiencing issues with the profiled muscle. The stretches identified in Functional Anatomy should not be performed within massage sessions or progressed by massage therapists, in order to comply with state laws and maintain scope of practice. 92 massage & bodywork may/june 2011